Women needing supplemental screening due to dense breast tissue have to travel nearly three times as far for breast MR or ultrasound compared to standard mammography, raising concerns about accessibility of essential screening for patients at higher risk of breast cancer.

A study, published in the American Journal of Preventive Medicine and conducted by the Harvey L. Neiman Health Policy Institute, analyzed data from 29,629 ZIP codes across the United States, comparing the average distances to facilities offering mammography, breast MR, and breast ultrasound. The findings showed that, on average, the distance to the nearest breast MR facility was 23.2 miles, while it was 8.2 miles for mammography and 22.2 miles for ultrasound.

This distance barrier is even more pronounced in socioeconomically disadvantaged areas, where residents are farther from all types of breast imaging facilities.
For those in metropolitan areas, breast MR was twice as far as mammography, and for those in small/rural areas, breast MR was three times as far.

“Breast MR is now being recommended as an additional screening tool for the 50% of women with dense breasts. Having dense breast tissue is a risk factor for breast cancer and can reduce breast cancer detection by mammography alone. When breast MR is not available or contraindicated, breast ultrasound and/or contrast-enhanced mammography (CEM) can be recommended as supplemental imaging techniques as well” stated Dr. Bhavika K. Patel, vice chair of research at Mayo Clinic Arizona. “The results of our study indicate there either needs to be a way to reduce the differences in access to breast MR or avail all patients of effective alternatives to promote early detection and improve outcomes.”

Patel emphasized the potential for CEM to help improve supplemental screening, which can be offered by mammography providers using the same equipment compared to the more expensive MR equipment. Although it would not solve disparities in breast MR access, she said it could mitigate the more important outcome differences.

Studies show that CEM has comparable diagnostic performance to breast MR, and many trials are currently underway to assess its screening performance.

Women's Health Homepage